Question

A 64-year-old woman comes to the office because of a 2-month history of progressive fatigue. She has hypertension currently treated with amlodipine. She does not smoke or use illicit drugs. She drinks two to three 12-oz beers nightly. Her pulse is 88/min, respirations are 16/min, and blood pressure is 124/68 mm Hg. Abdominal examination shows a palpable spleen. Results of laboratory studies are shown: Hemoglobin 8.9 g/dL Hematocrit 27% Mean corpuscular volume 78 um3 Leukocyte count 4700/mm3 Segmented neutrophils 65% Lymphocytes 25% Monocytes 7% Metamyelocytes 3% Reticulocyte count 3.4% Platelet count 165,000/mm3 A photomicrograph of a peripheral blood smear shows teardrop cells. Which of the following is the most likely cause of the findings in this patient? A) Aplastic anemia B) Cirrhosis C) Hemolytic anemia D) Myelofibrosis E) Renal failure

          A 64-year-old woman comes to the office because of a 2-month history of progressive fatigue. She has hypertension currently treated with amlodipine. She does not smoke or use illicit drugs. She drinks two to three 12-oz beers nightly. Her pulse is 88/min, respirations are 16/min, and blood pressure is 124/68 mm Hg. Abdominal examination shows a palpable spleen. Results of laboratory studies are shown:
Hemoglobin 8.9 g/dL
Hematocrit 27%
Mean corpuscular volume 78 um3
Leukocyte count 4700/mm3
Segmented neutrophils 65%
Lymphocytes 25%
Monocytes 7%
Metamyelocytes 3%
Reticulocyte count 3.4%
Platelet count 165,000/mm3
 
A photomicrograph of a peripheral blood smear shows teardrop cells. Which of the following is the most likely cause of the findings in this patient?
A) Aplastic anemia
B) Cirrhosis
C) Hemolytic anemia
D) Myelofibrosis
E) Renal failure

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Biology for AP Courses

Julianne Zedalis, John Eggebrecht

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Solved by Expert Bryan Valdivia

06/16/2023

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The patient has anemia (low hemoglobin and hematocrit) with a low mean corpuscular volume (MCV), indicating a microcytic anemia. Show more…

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A 64-year-old woman comes to the office because of a 2-month history of progressive fatigue. She has hypertension currently treated with amlodipine. She does not smoke or use illicit drugs. She drinks two to three 12-oz beers nightly. Her pulse is 88/min, respirations are 16/min, and blood pressure is 124/68 mm Hg. Abdominal examination shows a palpable spleen. Results of laboratory studies are shown: Hemoglobin 8.9 g/dL Hematocrit 27% Mean corpuscular volume 78 um3 Leukocyte count 4700/mm3 Segmented neutrophils 65% Lymphocytes 25% Monocytes 7% Metamyelocytes 3% Reticulocyte count 3.4% Platelet count 165,000/mm3 A photomicrograph of a peripheral blood smear shows teardrop cells. Which of the following is the most likely cause of the findings in this patient? A) Aplastic anemia B) Cirrhosis C) Hemolytic anemia D) Myelofibrosis E) Renal failure

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Transcript

00:01 Okay, this question here says a 64 year old woman comes to the office because of a two -month history of progressive fatigue.

00:06 So this patient has progressive fatigue.

00:16 Well, this patient is also 64 years old, but is an old patient.

00:23 And it says she has hypertension, currently treated with amlodipine.

00:28 She does not smoke or use illicit drugs.

00:31 She drinks 2 to 3 ounces of beers her pulse is 88, her respirations are 16, and blood pressure is normal.

00:41 And it says abdominal examination shows a palpable spleen.

00:44 So practically, there is hepatosplenomegaly.

00:49 Well, only spleenomegaly, because they are not telling us about the liver.

00:56 So spleenomegaly.

00:57 And it says the results of laboratory studies are shown.

01:00 So you have that this patient has low hemoglobin levels.

01:04 It means this patient has anemia.

01:05 What else? it says hematocrit is also low.

01:12 Mean corpuscular volume is 78.

01:14 So practically, this patient has microcytic anemia.

01:18 Or i'm sorry, well, yeah, microcytic anemia.

01:24 And now, okay, when you have low mcv, you have a microcytic anemia.

01:35 Now, then you have that the leukocyte count is 4 ,700.

01:41 So the leukocyte count is also low.

01:48 It is also low.

01:49 Then it says that segmented neutrophils is 65%.

01:51 The monocytes are 7%, and the metamyelocytes are 3%, and the glucocyte count is 3 .4%...

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